【摘要】 目的 探讨菌阴肺结核临床特点和诊断及治疗时限。方法 回顾分析5年间诊断菌阴肺结核523例，对其临床表现、X线特征等动态观察及治疗全程，每月痰涂检查3次，疗前、疗末痰菌培养各1次。结果 菌阴肺结核占同期初治肺结核78.1%，临床症状以咳嗽、咯血为主，但症状轻微，另2.7%无任何症状在体检时发现。常规剂量抗痨治疗全程后，疗末症状改善及X线显示吸收好转率100%。结论 菌阴肺结核临床症状轻微，以咳嗽、咯血、低热、盗汗为诊断线索，结合X线、实验室检查并排除其它疾病而综合判定。X线是诊断菌阴肺结核重要手段之一，强调集体读片作为常规。治疗这部分菌阴病人4月方案是可取的，以6～9月方案为宜。

    【关键词】 结核；肺；涂阴培阴

    The clinical analysis on 523 cases of sputum negative and cultivating sputum negative pulmonary tuberculosis

    ZHANG Bang-ming,WANG Ping.

    Yichang No.2 People’s Hospital,Yichang,Hubei 443000,China

    【Abstract】 Objective To discuss the clinical character of sputum negative pulmonary tuberculosis and its diagnosis as well as the time limitation of the treatment to it.Methods To recall and analyze the diagnosis on 523 cases of sputum negative pulmonary tuberculosis,dynamic observation and the whole procedure in treatment to its clinical showing and X rays feature in the past 5 years .Sputum was checked for 3 times every month.Sputum cultivating was made each once before the treatment and after it.Results Sputum negative pulmonary tuberculosis is 78.1%of the pulmonary tuberculosis treated at the same time originally.The clinical symptoms are mainly slight coughing and haemoptysis.Nothing had been found on another 2.7% in physical examination.Through the whole procedure of anti-tuberculosis treatment with common dosage, the rate of symptom improvement and assimilating function recovery shown by X rays is 100%.Conclusion Sputum negative pulmonary tuberculosis has slight clinical symptoms.It csn be determined in a comprehensive way by taking coughing,splitting blood, slight fever and profuse sweating as a diagnosis clue,through X rays and laboratory checking to eliminate other diseases.X rays is one of the important ways to diagnose sputum negative pulmonary tuberculosis.Collective reading on sputum should be a routine.4-month plan(6 to 9 months) is desirable to treat these patients. ......